Objective: To explore the value of REG3α, sST2 and TNFR1 in peripheral blood for risk stratification and prognostic evaluation of acute graft-versus-host disease (aGVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) in children.
Methods: From January 2020 to March 2022, 70 children with aGVHD after allo-HSCT in the First Affiliated Hospital of Zhengzhou University were selected as the research objects, of which 50 cases were mild aGVHD (grade I-II) and 20 cases were severe aGVHD (grade III-IV). 30 healthy children who underwent physical examinations in our hospital during the same period were selected as the control group. Luminex platform was used to detect the protein expression levels of REG3α, sST2 and TNFR1 during aGVHD occurrence, and the differences between the three groups were analyzed by one-way ANOVA. According to the outcome of aGVHD treatment within 28 days, the patients were divided into a good prognosis group of 58 cases and a poor prognosis group of 12 cases. The ROC curve was used to analyze the value of REG3α, sST2 and TNFR1 in predicting the prognosis of children with aGVHD.
Results: The peripheral blood levels of REG3α, sST2 and TNFR1 in the mild aGVHD and severe aGVHD groups were significantly higher than those in the control group (P <0.05), and those in the severe aGVHD group were significantly higher than those in the mild aGVHD group (P <0.05). Compared with the good prognosis group, the peripheral blood levels of REG3α, sST2 and TNFR1 in the poor prognosis group were significantly higher ( t =9.27,3.33,2.97; P <0.01). ROC curve analysis showed that the area under the curve (AUC), sensitivity and specificity of the combined detection of REG3α, sST2 and TNFR1 in predicting the prognosis of children with aGVHD were higher than those of the above indicators detected alone or in pairs.
Conclusion: The expression levels of REG3α, sST2 and TNFR1 were related to the severity of aGVHD. The combination of REG3α, sST2 and TNFR1 has a high clinical value in predicting the prognosis of children with aGVHD, which is expected to provide a reliable reference for clinical evaluation of the prognosis of children with aGVHD.
题目: REG3α、sST2、TNFR1在儿童异基因造血干细胞移植术后aGVHD危险分层及预后评估中的价值.
目的: 探讨外周血中REG3α、sST2、TNFR1对儿童异基因造血干细胞移植（allo-HSCT）术后aGVHD危险分层及预后评估的价值。.
方法: 选取2020年1月至2022年3月在郑州大学第一附属医院儿科行allo-HSCT后发生aGVHD的70例患儿作为研究对象，将并发Ⅰ-Ⅱ度aGVHD的50例患儿作为轻度aGVHD组，并发Ⅲ-Ⅳ度aGVHD的20例患儿作为重度aGVHD组，选取同期本院健康体检儿童30例作为对照组，通过Luminex平台检测aGVHD发生时REG3α、sST2、TNFR1蛋白表达水平，采用单因素方差分析比较3组间差异；根据aGVHD治疗28 d内病情转归情况将患儿分为预后良好组58例，预后不良组12例，利用ROC曲线分析REG3α、sST2、TNFR1对aGVHD患儿预后的评估价值。.
结果: 与对照组相比，轻度aGVHD组、重度aGVHD组外周血中REG3α、sST2、TNFR1水平均显著升高（P <0.05），且重度aGVHD组显著高于轻度aGVHD组（P <0.05）；与预后良好组相比，预后不良组aGVHD患儿外周血中REG3α、sST2、TNFR1水平均显著升高（ t =9.27，3.33，2.97；P <0.01）；ROC曲线分析结果表明，REG3α、sST2和TNFR1联合检测评估aGVHD患儿预后的曲线下面积（AUC）、灵敏性、特异性均高于各项指标单独检测及各指标两两组合检测。.
结论: REG3α、sST2、TNFR1表达水平与aGVHD严重程度相关；REG3α、sST2和TNFR1联合对于aGVHD患儿预后评估有较高的临床价值，有望为临床上评估aGVHD患儿预后提供可靠参考。.
Keywords: REG3α; sST2; TNFR1; children; acute graft-versus-host disease.